What is an Abfraction?
An abfraction is a small notch near the gum line, caused by stress on your teeth from grinding and clenching. Most people are unaware that they grind or clench their teeth because it happens at night while asleep. Grinding and clenching puts pressure on your teeth an overtime cause cracks and splits in the outer layer of your teeth. This occurs in the thinnest part of your enamel, near the gum line. When your bite is slightly off, it’s common that one tooth may hit sooner than the rest. This causes undue stress on the involved teeth and they begin to flex. It’s this continual flexing and stress that, over time, causes the enamel to separate from the inner dentin layer, forming the familiar looking notch associated with an abfraction. Sometimes a combination of hard toothbrush bristles and improper brushing techniques can cause enamel to be lost at the gum line, but this is not the cause of abfraction.
Mild abfraction lesions don’t usually hurt, although they can collect plaque bacteria and be more susceptible to decay. In severe cases, the dentin and cementum layers of a tooth become exposed and because of this they can hurt as well as become more cavity prone. Dentin is the layer below the enamel. Cementum covers the tooth root instead of enamel. Dentin may be exposed if a crack develops. In these cases, the tooth may become sensitive. Otherwise, the lesions do not cause symptoms.
Abfractions are typically treated with a bonded tooth-colored filling to protect from further notching and possible damage to the nerve. Tooth colored fillings can repair the damage and restore the tooth to its original color and shape. Following the filings, an appliance called a Night Guard is usually advised. A night guard is a custom designed appliance made in a lab that fits over your top teeth and is worn nightly. Dr. Michaelson can make you a custom night guard check out our Night Guard services page. This guard is made specifically for your bite and holds your jaw into an ideal position to reduce or eliminate grinding and clenching. A guard protects and absorbs the stress on your teeth and typically need to be replaced every 3-5 years depending on wear.